Alopecia Areata: Evidence-Based Treatments

March 2009 in “ Seminars in cutaneous medicine and surgery ”

Seema Garg, A.G. Messenger

alopecia areata nonscarring hair loss corticosteroids topical sensitizers PUVA minoxidil dithranol Rogaine

TLDR Alopecia areata can cause unpredictable hair loss, and treatments like corticosteroids and minoxidil may help but have varying side effects.

Alopecia areata is a condition causing nonscarring hair loss that can be patchy or affect the entire scalp or body. While some patients recover spontaneously, others may experience recurrent relapses or persistent hair loss, leading to significant psychological distress. Effective management includes counseling about the condition's unpredictable nature and available treatments, which have varying side effects. Common treatments reviewed include corticosteroids, topical sensitizers, PUVA, minoxidil, and dithranol, though data on their long-term efficacy and impact on quality of life were limited.

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Research cited in this study

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research Interventions for Alopecia Areata

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Current treatments for alopecia show no significant long-term benefits.

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Certain genes on chromosomes 6, 10, 16, and 18 may increase the risk of alopecia areata.

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The new clobetasol propionate foam is effective and safe for treating alopecia areata.

research Guidelines for the Management of Alopecia Areata

182 citations, October 2003 in “British Journal of Dermatology”

The 2003 guidelines suggest that while some treatments can regrow hair in alopecia areata, none alter the disease's progression, and wigs may be the best option for extensive hair loss.

research Clobetasol Propionate 0.05% Under Occlusion in the Treatment of Alopecia Totalis/Universalis

146 citations, July 2003 in “Journal of the American Academy of Dermatology”

Clobetasol propionate ointment can help some people with total hair loss regrow hair.

Efficacy of Betamethasone Valerate Foam Formulation in Comparison with Betamethasone Dipropionate Lotion in the Treatment of Mild-to-Moderate Alopecia Areata: A Multicenter, Prospective, Randomized, Controlled, Investigator-Blinded Trial

research Efficacy of Betamethasone Valerate Foam Formulation in Comparison with Betamethasone Dipropionate Lotion in the Treatment of Mild-to-Moderate Alopecia Areata: A Multicenter, Prospective, Randomized, Controlled, Investigator-Blinded Trial

66 citations, July 2003 in “International Journal of Dermatology”

Betamethasone valerate foam is more effective and safe for treating mild-to-moderate alopecia areata than betamethasone dipropionate lotion.

research Sulfasalazine for Alopecia Areata

62 citations, April 2002 in “Journal of the American Academy of Dermatology”

Sulfasalazine may help regrow hair in severe alopecia areata cases.

research Efficacy of Topical Sensitizers in the Treatment of Alopecia Areata

132 citations, November 1998 in “Journal of the American Academy of Dermatology”

Topical sensitizers have mixed success in treating alopecia areata.

research The Pathogenesis of Alopecia Areata

89 citations, October 1996 in “Dermatologic Clinics”

Alopecia areata is likely caused by a combination of genetic factors and immune system dysfunction, and may represent different diseases with various causes.

research Pulsed Administration of Corticosteroids in the Treatment of Alopecia Areata

117 citations, February 1996 in “International Journal of Dermatology”

A 300 mg monthly pulse of prednisolone effectively and safely treats widespread alopecia areata.

research PUVA Treatment of Alopecia Areata Partialis, Totalis, and Universalis: Audit of 10 Years' Experience at St John's Institute of Dermatology

105 citations, December 1995 in “British journal of dermatology/British journal of dermatology, Supplement”

PUVA treatment is generally ineffective for alopecia areata.

research Vitiligo Complicating Diphencyprone Sensitization Therapy for Alopecia Universalis

47 citations, September 1995 in “British Journal of Dermatology”

Diphencyprone therapy for hair loss can cause vitiligo.

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101 citations, November 1992 in “Archives of Dermatology”

Steroids help hair regrowth, and minoxidil slows post-steroid hair loss, but effects are temporary.

research Alopecia Areata in Children: Response to Treatment with Diphencyprone

84 citations, August 1991 in “British Journal of Dermatology”

Most children treated with diphencyprone regrew some or all of their hair.

research Evaluation of Anthralin in the Treatment of Alopecia Areata

109 citations, November 1987 in “Archives of dermatology”

Anthralin cream helped 25% of patients with severe alopecia areata regrow hair, but caused skin irritation.

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104 citations, March 1987 in “Journal of The American Academy of Dermatology”

Minoxidil helps hair growth in 63.6% of alopecia patients, with 27.3% having excellent results.

research Topical Photochemotherapy for Alopecia Areata

63 citations, April 1985 in “Journal of the American Academy of Dermatology”

Topical PUVA can cause temporary hair regrowth in some alopecia areata patients but doesn't change the long-term outcome.

research Alopecia Areata: Pathogenesis And Treatment

122 citations, November 1984 in “Journal of the American Academy of Dermatology”

No single treatment is consistently effective for alopecia areata, and more research is needed.

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80 citations, November 1975 in “Acta dermato-venereologica”

Large doses of glucocorticoids are not suitable for general use in treating severe alopecia areata due to inconsistent results and risks.

research A Comparison of Intralesional Triamcinolone Hexacetonide and Triamcinolone Acetonide in Alopecia Areata

75 citations, September 1971 in “British Journal of Dermatology”

Both steroids effectively promote hair growth for at least 9 months.

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